Chronic Care Management in Massachusetts.
Non-face-to-face care coordination for patients with multiple chronic conditions. Medicare billing, MassHealth coverage, and compliance details for Massachusetts providers.
How does CCM work for providers in Massachusetts?
Chronic Care Management (CCM) enables Massachusetts providers to bill Medicare for non-face-to-face care coordination using CPT codes 99490, 99491, 99439. Patients with two or more chronic conditions qualify — common combinations in Massachusetts include heart disease, diabetes, COPD. Medicare covers CCM federally for patients with 2+ chronic conditions. MassHealth provides full supplementary coverage. Serving 1.1M seniors with +12% by 2035 projected growth, Massachusetts's CCM market is expanding. CCN Health manages clinical workflows, care plan documentation, and monthly billing — integrating with 5+ major health systems including Mass General Brigham and Beth Israel Lahey Health running CCM programs.
Medicare Billing
CCM billing in Massachusetts.
CCM uses federally standardized CPT codes with uniform reimbursement across Massachusetts. MassHealth provides full supplementary Medicaid coverage for dual-eligible patients.
CCM services, first 20 min of clinical staff time per month
CCM services requiring physician/QHP, first 30 min/month
Each additional 20 min of CCM clinical staff time
~$80-$130/mo per patient
20 minutes of non-face-to-face care coordination per month (99490); 30 minutes for complex CCM (99491)
Medicare covers CCM federally for patients with 2+ chronic conditions. MassHealth provides full supplementary coverage.
Billing Requirements
Patient must have two or more chronic conditions expected to last at least 12 months
Comprehensive care plan must be established and maintained
Patient consent documented in medical record
24/7 access to care team required
Continuity of care with designated practitioner
Massachusetts Medicaid Supplement
MassHealth provides full supplementary coverage for dual-eligible CCM patients. Providers can bill both Medicare and Medicaid to maximize reimbursement for CCM services. Massachusetts's telehealth parity law supports remote CCM delivery at equivalent reimbursement rates.
Regulatory Landscape
CCM compliance in Massachusetts.
Beyond federal Medicare requirements, Massachusetts has specific telehealth, licensure, and privacy regulations that affect CCM programs.
Telehealth Parity
- *Massachusetts has telehealth parity legislation requiring CCM services to be reimbursed at equivalent rates compared to in-person visits.
- *Massachusetts has strong telehealth parity. MassHealth was among the first to cover remote monitoring comprehensively.
Interstate Licensure
- *Massachusetts is not currently a member of the Interstate Medical Licensure Compact. Providers delivering CCM services must hold a valid Massachusetts medical license.
EHR Integrations
CCM-compatible EHRs.
Major Massachusetts health systems like Mass General Brigham and Beth Israel Lahey Health use EHR platforms that CCN Health integrates with. Each integration includes automated CCM documentation, billing, and clinical workflows.
PointClickCare
665 integration guides
ALIS
663 integration guides
MatrixCare
663 integration guides
August Health
663 integration guides
Ethizo
240 integration guides
athenahealth
240 integration guides
Charm Health
240 integration guides
Epic
240 integration guides
FAQ
CCM in Massachusetts questions.
Massachusetts's dense healthcare market and 5+ major health systems like Mass General Brigham and Beth Israel Lahey Health create strong infrastructure for CCM adoption. MassHealth provides full supplementary coverage, maximizing dual-eligible revenue. High prevalence of heart disease, diabetes, COPD among Massachusetts's patient population drives CCM enrollment.
MassHealth provides full supplementary coverage for CCM services. Medicare covers CCM federally for patients with 2+ chronic conditions. MassHealth provides full supplementary coverage. For dual-eligible beneficiaries, providers can bill both Medicare and Medicaid to maximize reimbursement.
Massachusetts has telehealth parity legislation requiring CCM services to be reimbursed at equivalent rates compared to in-person visits. Massachusetts has strong telehealth parity. MassHealth was among the first to cover remote monitoring comprehensively.
With 1.1M residents aged 65+, Massachusetts has a large CCM-eligible population — patients with two or more chronic conditions. Common multi-morbidity combinations in Massachusetts include heart disease with diabetes, and COPD with heart disease. Massachusetts's +12% by 2035 senior population growth means CCM demand is accelerating.
Massachusetts has approximately 1.1M residents aged 65+ (16.5% of the population), with +12% by 2035 projected growth. World-class academic medical centers drive innovation. Dense senior living market in greater Boston. Strong value-based care adoption creates demand for remote monitoring.
CCM in Massachusetts must comply with federal Medicare billing requirements and HIPAA. Massachusetts does not currently have a comprehensive state privacy law beyond HIPAA, but standard patient consent and data security requirements apply. Massachusetts is not part of the Interstate Medical Licensure Compact — providers must hold a valid Massachusetts license to deliver CCM services. Massachusetts has strong telehealth parity. MassHealth was among the first to cover remote monitoring comprehensively.
Massachusetts Regulatory Sources
This page provides general informational guidance only and does not constitute legal, compliance, or billing advice. Telehealth regulations, Medicaid coverage, and state privacy laws change frequently. Verify current requirements with your state health department, payers, and qualified healthcare compliance counsel before making program decisions. Demographic data is based on U.S. Census Bureau estimates. Data last verified: March 2026.
Other Programs
More programs in Massachusetts.
Explore other Medicare remote care programs available to Massachusetts providers.
RPM
Remote Patient Monitoring
Real-time vital sign monitoring with FDA-cleared cellular devices.
PCM
Principal Care Management
Focused management of a single high-complexity chronic condition.
BHI
Behavioral Health Integration
Behavioral health screening and collaborative care in primary care settings.
RTM
Remote Therapeutic Monitoring
Therapy outcome monitoring for musculoskeletal and respiratory rehabilitation.